CPT 22103
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Remove extra spine segment
Low
$47
Average
$1.4k
Median
$273
High
$11.5k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
52 payers; the 90th percentile is 29.2× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare fee schedule · outpatient · +6 other terms | 245 | $1.0k | $1.7k | $2.4k | 147% | — | $23 – $17.9k |
| 2 | Aetna fee schedule · outpatient · +5 other terms | 184 | $2.6k | $5.4k | $7.4k | 136% | — | $21 – $37.3k |
| 3 | Cigna fee schedule · outpatient · +6 other terms | 139 | $9.6k | $14.0k | $12.0k | 86% | — | $34 – $52.9k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +5 other terms | 105 | $1.5k | $5.2k | $7.4k | 143% | — | $0 – $58.9k |
| 5 | Humana fee schedule · outpatient · +6 other terms | 102 | $128 | $1.6k | $3.2k | 201% | — | $104 – $14.4k |
| 6 | Anthem fee schedule · outpatient · +4 other terms | 86 | $211 | $616 | $1.7k | 271% | — | $115 – $13.7k |
| 7 | Kaiser fee schedule · outpatient · +4 other terms | 40 | $128 | $140 | $45 | 32% | — | $23 – $322 |
| 8 | Molina fee schedule · outpatient · +5 other terms | 40 | $262 | $1.0k | $1.8k | 175% | — | $18 – $9.2k |
| 9 | WellCare fee schedule · both · +5 other terms | 30 | $109 | $117 | $50 | 43% | — | $0 – $227 |
| 10 | Devoted fee schedule · outpatient · +4 other terms | 21 | $128 | $127 | $1 | 1% | — | $125 – $128 |
| 11 | Regence professional · fee schedule · outpatient | 21 | $21 | $47 | $76 | 162% | — | $21 – $334 |
| 12 | Bcbs La fee schedule · outpatient · +1 other terms | 19 | $11.2k | $10.8k | $2.9k | 27% | — | $0 – $15.4k |
| 13 | Medicare fee schedule · outpatient · +5 other terms | 18 | $126 | $124 | $3 | 2% | — | $115 – $128 |
| 14 | Optum professional · fee schedule · outpatient · +3 other terms | 16 | $105 | $85 | $41 | 48% | — | $14 – $137 |
| 15 | Oscar facility · fee schedule · outpatient · +3 other terms | 16 | $3.6k | $3.6k | $1.1k | 29% | — | $2.6k – $4.7k |
| 16 | Caresource fee schedule · outpatient · +4 other terms | 15 | $1.9k | $1.7k | $558 | 33% | — | $130 – $1.9k |
| 17 | Medica fee schedule · outpatient · +4 other terms | 15 | $242 | $362 | $201 | 56% | — | $104 – $731 |
| 18 | Ambetter fee schedule · both · +4 other terms | 13 | $172 | $216 | $69 | 32% | — | $0 – $258 |
| 19 | Wellmark fee schedule · both · +1 other terms | 13 | $233 | $233 | $69 | 30% | — | $118 – $302 |
| 20 | Aetna Better Health fee schedule · outpatient · +6 other terms | 12 | $133 | $129 | $5 | 4% | — | $123 – $133 |
| 21 | Amerihealth Caritas fee schedule · both · +3 other terms | 12 | $109 | $109 | — | — | — | $109 – $109 |
| 22 | Bcbs Mn fee schedule · outpatient · +3 other terms | 12 | $3.0k | $1.9k | $1.6k | 87% | — | $0 – $3.7k |
| 23 | Cigna Healthspring fee schedule · both · +1 other terms | 12 | $120 | $121 | $2 | 1% | — | $120 – $126 |
| 24 | Highmark fee schedule · outpatient · +4 other terms | 12 | $147 | $294 | $981 | 334% | — | $84 – $9.2k |
| 25 | MultiPlan fee schedule · both · +4 other terms | 12 | $242 | $255 | $54 | 21% | — | $211 – $429 |
← Hospitals reporting CPT 22103 · Snapshot 20261113T090226Z-3ce6c0b8